بررسي اثر تمرينات اكسنتريك و كانسنتريك بر شاخص هاي فشار خون و ضربان قلب در بيماران مبتلا به ديابت نوع 2

Effects of eccentric and concentric exercises on blood pressure and heart rate parameters in type 2 diabetes

ﺳﺎﺑﻘﻪ و ﻫﺪف: ﺣﺪود 7% ﺟﻤﻌﯿﺖ دﻧﯿﺎ ﺑﻪ دﯾﺎﺑﺖ ﻣﺒﺘﻼ ﻫﺴﺘﻨﺪ و از ﻋﻮارض ﮔﺴـﺘﺮده آن رﻧـﺞ ﻣـﯽﺑﺮﻧـﺪ. ﻣﻄﺎﻟﻌـﺎت ﻣﺘﻌﺪدي درﺑﺎره اﺛﺮات ﻣﻔﯿﺪ ﺗﻤﺮﯾﻨﺎت ﻫﻮازي و ﻣﻘﺎوﻣﺘﯽ ﺑﺮ ﻓﺸﺎر ﺧﻮن و ﺿﺮﺑﺎن ﻗﻠﺐ ﺑﯿﻤـﺎران ﻣﺒـﺘﻼ ﺑـﻪ دﯾﺎﺑـﺖ ﻧـﻮع 2 ﻣﻮﺟﻮد ﻣﯽ ﺑﺎﺷﺪ، ﺑﺎ وﺟﻮد اﯾﻦ ﮐﻪ ﺗﻤﺮﯾﻨﺎت اﮐﺴﻨﺘﺮﯾﮏ ﻣﻮﺟﺐ ﺑﻬﺒﻮد ﺣﺠﻢ ﺿﺮﺑﻪ اي، ﺑﺮون ده ﻗﻠﺒﯽ و اﮐﺴﯿﮋن ﻣﺼﺮف ﺷﺪه و ﮐﺎﻫﺶ ﻓﺸﺎر ﺑﺮ ﺳﯿﺴﺘﻢ ﻗﻠﺒﯽ-ﻋﺮوﻗﯽ ﻣﯽ ﺷﻮد، وﻟﯽ ﺗﺎﮐﻨﻮن ﻣﻄﺎﻟﻌﻪ اي اﺛﺮ ﺗﻤﺮﯾﻨﺎت اﮐﺴﻨﺘﺮﯾﮏ ﺑﺮ اﯾﻦ ﺷـﺎﺧﺺﻫـﺎ در ﺑﯿﻤﺎران دﯾﺎﺑﺘﯿﮏ را ﺑﺮرﺳﯽ ﻧﮑﺮده اﺳﺖ. ﻫﺪف از ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺮرﺳﯽ اﺛـﺮ ﺗﻤﺮﯾﻨـﺎت اﮐﺴـﻨﺘﺮﯾﮏ و ﮐﺎﻧﺴـﻨﺘﺮﯾﮏ ﺑـﺮ ﺷﺎﺧﺺ ﻫﺎي ﻓﺸﺎر ﺧﻮن و ﺿﺮﺑﺎن ﻗﻠﺐ ﺑﯿﻤﺎران دﯾﺎﺑﺘﯿﮏ ﻧﻮع 2 ﻣﯽ ﺑﺎﺷﺪ. ﻣﻮاد و روش ﻫﺎ: 28 ﺑﯿﻤﺎر ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑﺖ ﻧﻮع 2 ﺑﻪ ﻃﻮر ﺗﺼﺎدﻓﯽ در دو ﮔـﺮوه (7ﻣـﺮد و 7 زن در ﻫـﺮ ﮔﺮوه) ﺗﻤﺮﯾﻨـﺎت اﮐﺴﻨﺘﺮﯾﮏ و ﮐﺎﻧﺴﻨﺘﺮﯾﮏ ﺑﻪ ﻣﺪت 8 ﻫﻔﺘﻪ (3 ﺟﻠﺴﻪ در ﻫﻔﺘـﻪ) ﺑـﺎ اﺳـﺘﻔﺎده از ﺗﺮدﻣﯿـﻞ ﻗـﺮار ﮔﺮﻓﺘﻨـﺪ. ﻓﺸـﺎر ﺧـﻮن ﺳﯿﺴﺘﻮﻟﯿﮏ، دﯾﺎﺳﺘﻮﻟﯿﮏ و ﺿﺮﺑﺎن ﻗﻠﺐ، ﻗﺒﻞ و ﺑﻌﺪ از دوره ﮐﻨﺘﺮل و ﻣﺪاﺧﻠﻪ در ﻫﺮ دو ﮔﺮوه ﺑﺮرﺳﯽ ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: داده ﻫﺎ ﻧﺸﺎن ﻣﯽ دﻫﺪ ﮐـﻪ ﺗﻤﺮﯾﻨـﺎت ﮐﺎﻧﺴـﻨﺘﺮﯾﮏ (0/005>P) و اﮐﺴـﻨﺘﺮﯾﮏ (0/0001>P) ﻣﻮﺟـﺐ ﺑﻬﺒـﻮد ﻣﻌﻨﯽ دار ﻓﺸﺎر ﺧﻮن و ﺿﺮﺑﺎن ﻗﻠﺐ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑﺖ ﻣﯽ ﺷﻮﻧﺪ وﻟﯽ ﺗﻤﺮﯾﻨﺎت اﮐﺴﻨﺘﺮﯾﮏ ﻧﺴﺒﺖ ﺑﻪ ﮐﺎﻧﺴـﻨﺘﺮﯾﮏ ﺑﺎﻋﺚ ﮐﺎﻫﺶ ﻣﻌﻨﯽ دارﺗﺮي در ﻓﺸﺎر ﺧﻮن ﺳﯿﺴـﺘﻮﻟﯿﮏ (0/0001>P)، دﯾﺎﺳـﺘﻮﻟﯿﮏ (0/0001>P) و ﺗﻌـﺪاد ﺿـﺮﺑﺎن ﻗﻠـﺐ (0/0001>P) در اﯾﻦ دﺳﺘﻪ از ﺑﯿﻤﺎران ﻣﯽ ﮔﺮدد. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: از ﯾﺎﻓﺘﻪ ﻫﺎي اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﻧﻈﺮ ﻣﯽ رﺳﺪ ﮐﻪ ﺗﻤﺮﯾﻨﺎت اﮐﺴﻨﺘﺮﯾﮏ و ﮐﺎﻧﺴﻨﺘﺮﯾﮏ ﻣﻮﺟـﺐ ﺑﻬﺒـﻮد ﻣﯿـﺰان ﻓﺸﺎر ﺧﻮن ﺳﯿﺴﺘﻮﻟﯿﮏ و دﯾﺎﺳﺘﻮﻟﯿﮏ و ﺗﻌﺪاد ﺿﺮﺑﺎن ﻗﻠﺐ ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑـﺖ ﻧـﻮع 2 ﻣـﯽﮔـﺮدد وﻟـﯽ ﺗﻤﺮﯾﻨـﺎت اﮐﺴﻨﺘﺮﯾﮏ اﺛﺮات ﺳﻮدﻣﻨﺪ ﺑﯿﺶ ﺗﺮي ﻧﺴﺒﺖ ﺑﻪ ﺗﻤﺮﯾﻨﺎت ﮐﺎﻧﺴﻨﺘﺮﯾﮏ در اﯾﻦ ﺑﯿﻤﺎران دارﻧﺪ.

Introduction: About 7% of world populations are suffered from diabetes disease and its widespread complications. There are several studies about the beneficial effects of aerobic and resistance exercises on blood pressure and heart rate parameters in type 2 diabetic patients. Although, eccentric exercise may improve stroke volume, cardiac output and oxygen consumption and reduces the load on the cardiovascular system, there is no study to investigate the effects of eccentric exercise on these parameters in these patients. The aim of the present study was to investigate the effect of eccentric and concentric exercises on blood pressure and heart rate parameters in type 2 of diabetic patients. Materials and Methods: 28 type 2 diabetic patients were assigned randomly in one of the two experimental eccentric and concentric groups (7 male and 7 female in each group) using treadmill for 8 weeks (3 session per week). Before and after intervention, systolic and diastolic blood pressures and heart rate were measured. Results: The data shows that heart rate and blood pressure may significantly reduce by botheccentric (P<0.0001) and concentric (P<0.005) exercises training, while eccentric exercise caused more significantly reduction in systolic (P<0.0001) and diastolic (P<0.0001) blood pressures and heart rate (P<0.0001) than the concentric exercise. Conclusion: From these findings, it seems that both eccentric and concentric exercisesmay improve heart rate and systolic and diastolic blood pressure in type 2 diabetic patients, while eccentric exercise may have more beneficial effect than the concentric exercises in these patients.